"All Hands on Deck": A Systematic Review of Concussion Guidelines Across All Sailing Sports and a Call to Action

Background: Sports-related concussions are complex, traumatic brain injuries as a result of a sporting accident. Prompt diagnosis and assessment with the use of diagnostic protocols help provide athletes with the appropriate management to minimise acute and chronic implications. Objective: The objective of this systematic review is to review the current sailing concussion assessment and diagnostic guidelines and consequently propose a sailing concussion assessment and diagnostic protocol to use. Methods: Sailing organisations such as "World Sailing" were used to find current guidelines used in the sailing community. Electronic databases such as Google Scholar, Springer Link, and PubMed were used to identify relevant scientific papers. Keywords included "sailing", "concussion", "guidelines", "sailing legislation", and "sports-related concussion". This systematic review is not limited to a specific sailing subtype. We included papers discussing concussion guidelines and excluded studies with no relevance to sports related concussions and without relevant guideline use. Findings were summarised in in text and tables. Results: While there is much research discussing head injuries in sailing, there is no literature specifically discussing protocols and guidance for concussion diagnosis and management in sailing-related concussions. Six concussion protocol papers are discussed. The World Sailing website advises individuals to use the CRT5 guidelines to assess a suspected concussion, which have been outdated by CRT6. While there are currently no standardised sailing-specific concussion assessment tools available, this review proposes a possible approach, introducing the concussion protocol used in the professional sailing league, SailGP. A sport-specific protocol is vital in addressing the specific risks associated with a sailing-related concussion. Conclusions: Concussions are a considerable risk in sailing due to the unique nature of the sport. Due to the lack of standardised concussion guidelines within the sailing community, a standardised, sport-specific concussion assessment tool, such as the one described for SailGP, should be developed through collaboration between medical professionals and sailing organisations.